Abstract
Chris Anderson, Editor in Chief
If you had asked me three months ago what the topic of my editorial would be this issue, I'd have said the 20th anniversary of the announcement of the completion of the Human Genome Project. (see page 26 “The Human Genome Project at 20”)
Unfortunately, we have arrived in the Spring of 2020 deeply mired in a pandemic, the likes of which hasn't occurred in more than 100 years. As you'll see thumbing through this issue, we have devoted nearly the first half of our magazine to extended coverage of COVID-19, the efforts to fast-track our understanding of the virus, how to treat it, how to detect it, and even how it has affected other areas of healthcare.
One of the ripples of the response by health systems to prepare for treating COVID-19 patients has been seen in cancer testing and cancer care. A recent report by diagnostics commercialization specialist Diaceutics LLC showed a marked decline in the number of newly diagnosed patients across a range of cancer types. Lung cancer diagnoses alone had dropped by more than 30% since the beginning of social distancing and the restriction of health services in response to the pandemic. Similar declines were seen in colorectal, breast, and ovarian cancers, as well as acute myeloid leukemia.
Rest assured, the incidence rate of these diseases has not declined. But the ability to test for them has encountered a significant roadblock in conjunction with restrictions on people's ability to visit their primary care physician, or oncologist, or hematologist—the frontlines of cancer diagnosis and treatment. The report from Diaceutics also showed declines in testing for biomarkers related to, and implicated in, these cancers such as KRAS and EGFR mutations—the very testing that allows clinicians to select the most appropriate treatments for a patient's specific type of cancer.
So an adjunct effect of the COVID-19 pandemic has been to throw a monkey wrench into clinicians' ability to get a jump on treating both newly diagnosed and relapsed cancer patients. With the understanding that we may be in for various periods of social distancing for the foreseeable future, it is obvious that new models of cancer diagnosis are in order.
Luckily, some molecular diagnostics companies serving other areas in health-care, such as pharmacogenomics and carrier screening, may have provided some of the answers for how to continue providing services for patients via home testing. (see page 19 “Staying Relevant”) This also could be the time for non-invasive cancer testing in the form of liquid biopsies to shine. While it's obviously not possible for at-home testing to generate tissue samples, creative approaches should be employed in the coming months to ensure that those battling cancer, or those suspected of having the disease, can safely provide a biological sample in order to continue to get the timely diagnoses their doctors need to provide the most effective, timely, and targeted care available.